Theses and dissertations (Health Sciences)
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Item Developing academic and clinical collaboration guidelines for nurse training at a public nursing college in KwaZulu-Natal, South Africa(2024) Maharaj, Sangeetha; Ngxongo, Thembelihle Sylvia Patience; Razak, AyishaIntroduction and background Global reports of theory, practice gaps, decreased levels of competency and challenges with utilising clinical reasoning amongst newly qualified nurse graduates, have created a major concern in a complex healthcare environment, which requires efficiency. In South Africa, like most African countries, the healthcare system is predominantly nurse-driven, requiring nurses to have the necessary competencies and expertise to effectively manage the country’s disease burden and meet the healthcare needs of the South African community. Challenges have however, been identified in the clinical training of nurses which may impact on their graduate competency. These challenges may be attributed to deficiencies in the integration of theory and practice, and clinical support provision for nursing students. Aim of the study The aim of the study was to develop academic and clinical collaboration guidelines for nurse training at a public nursing college in KwaZulu-Natal, South Africa. Objectives of the study The objectives of the study were: to gain in-depth insight into the practices for clinical education of nursing students at a public nursing college in KwaZulu-Natal; explore and describe the role of the nursing educator with regards to clinical accompaniment and clinical teaching; explore and describe the experiences of the clinical ward staff in supervision and mentoring of nursing students; explore and describe the experiences of student nurses regarding clinical teaching and learning and develop guidelines for academic and clinical collaboration for nurse training in public nursing colleges. Research Method A qualitative exploratory design with a constructivist approach was utilised. Ethics approval was obtained from the: Durban University of Technology Institutional Research Ethics (Irec. No. 200/21). All participants, which comprised 49 academic staff, 43 professional nurses and 21 students registered in the Diploma in Nursing Programmes, were purposively sampled. Data were collected using focus group discussions and one-on-one semistructured interviews conducted between January and May 2022 and analysed manually using the content analysis strategy and following the eight-step analysis procedure by Tesch (1990). Findings The study findings revealed five themes namely: ineffectual clinical training structure; inadequate collaboration and supportive relationship between the academic institution and clinical placement area; clinical placement institutional challenges, clinical preparedness of students prior to clinical allocations and graduate competency not guaranteed on completion of training. These factors posed challenges to nursing students meeting their mandatory training objectives during their placements. The guiding principles of Schünemann, Fretheim and Oxham (2006), were utilised to develop guidelines for facilitating academic and clinical collaboration for nurse training at a public nursing college in the province of KwaZulu-Natal, South Africa. The Delphi technique was utilised to incorporate inputs from expert members on the group. Conclusion Challenges being experienced during the clinical learning placements of nursing students at this college, could result in theory and practice gaps during and after training. The guidelines developed, aims at enhancing the collaborative relationships between the academic and clinical partners in nurse training and can be used by the management of both structures who are responsible for nurse training, to improve the clinical training platforms. Recommendations The study recommendations are aimed at strengthening clinical training platforms for students at Public Nursing Colleges and includes: improving collaborative relationships between the academic and clinical partners in nurse training; planning together with clinical stakeholders for all resources required; prioritising nursing students meeting their clinical objectives and developing mutual nurturing relationships. A need exists to address challenges of student supervision, mentoring, negative staff attitudes and a lack of standardised clinical practice between the academic and clinical training partners. A review of the system of clinical preparation, accompaniment, and supervision of nursing students is critical.Item Exploring the supernumerary status of student nurses in the clinical learning environment at two selected private nursing colleges in Durban, Kwa-Zulu Natal(2022-05-13) Naidoo, Roshini; Razak, A.; Naidoo, V.Background Nursing is a practice whereby learning in the clinical environment is just as important as the theoretical component. While specialised training and an abundance of knowledge and skill is required to synchronise patient care with the increased burden of disease globally, a report by the International Council of Nurses, has found that major changes in any healthcare system necessitates the need for nurses to upskill and acquire knowledge for the transition from a novice nurse to an expert. This has made clinical supervision necessary for the experiential foundation for nursing knowledge, skills, and values, allowing it to be to be integrated and applied in the clinical environment. Purpose of the study The purpose of the study was to describe the current role of student nurses registered in the Diploma in General Nursing programme and to explore the perceptions of student nurses of their supernumerary role in the clinical learning environment. Methodology A qualitative, exploratory, descriptive design, was adopted, to explore the supernumerary status of student nurses in the clinical learning environment at two selected private nursing colleges in Durban, a city in the province of KwaZuluNatal, South Africa. Data was collected from in-depth, one-on-one interviews with twenty student nurses and the findings were analysed using Creswell’s step-bystep approach to data analysis. Findings Four major themes that emerged from the data analysis were a) Integration of theory and practice; b) Influences relating to the teaching and learning area; c) Supervision of nursing students; d) Communication. Conclusion Nursing care is a core element in the clinical environment as knowledge and skills are an integral part of clinical practice in a healthcare facility. Patient care has been given top priority in South Africa by SANC, Department of Health (DoH) the Council on Higher Education (CHE), legislation, guidelines, procedures and programmes, hence there was a need to change the nursing curriculum in 2020. The findings of this study hopefully, will generate awareness for the need to support and guide student nurses in achieving the specific learning outcomes as stipulated in the SANC curriculum, by allowing clinical practice opportunities. Therefore, an understanding of the evolving changes in the SANC curriculum regarding student nurses functioning under a supernumerary status in the clinical learning environment, will significantly contribute to the accomplishment of competent graduate nurses rendering holistic patient care.Item Factors influencing student midwives’ academic performance in selected campuses of KwaZulu-Natal College of Nursing: exploring students’ perspectives(2020-06) Mahadeo, Shamin; Ngxongo, Thembelihle Sylvia PatienceIntroduction and background Midwifery training prepares student midwives from diverse cultural and social backgrounds and beliefs to render competent care to mothers and babies. Midwifery training should aim to produce qualified midwives who are able to practice midwifery independently as prescribed by the South African Nursing Council (SANC). The education of student midwives demands more than the traditional lecture method of teaching. Practical skills are of importance, but cannot be practiced without the theoretical knowledge. Therefore, midwifery lecturers are faced with a challenge of ensuring an education that is firmly grounded in theory and practice. The ability to apply theoretical knowledge to clinical performance is fundamental in creating competent midwives. The average pass rate of 9.6%-31% for theory examinations, recorded for the past few years, is evidence of the high failure rate in the SANC R254 midwifery programme across South Africa. This has an implication on the production of an adequate number of competent midwives to render quality midwifery services. Aim of the study: The aim of the study was to describe the factors that, according to student midwives’ perspectives, could have influenced their academic performance, thus resulting in repeated failure in the R254 midwifery programme in selected campuses of the KwaZuluNatal College of Nursing (KZNCN). Objectives of the study: The objectives of the study were to explore and describe student, lecturer and institutional related factors that could have influenced the academic performance of the student midwives in the R254 programme, in selected campuses of the KZNCN, and to describe student midwives’ perspectives regarding the factors that could facilitate their academic performance. Method: A non-experimental, quantitative, descriptive, survey design was undertaken, guided by the Empowered Holistic Nursing Education (EHNE) theory. In September and October 2018, data was collected from 122 student midwives of the R254 programme from four campuses in UMgungundlovu and eThekwini Districts in KwaZulu-Natal, using selfadministered questionnaires. Findings: The study findings revealed that the student midwives’-related factors that could have influenced academic performance pointed to personal factors, study habits and self-interest. The lecturer-related factors included the student-lecturer relationship, teaching strategies and remedial work, while the institution-related factors were the availability of human and material resources. The majority of the respondents highlighted student motivational factors, a positive student-teacher relationship and study habits especially group study, as the factors that could facilitate the academic performance of students of the R254 midwifery programme. Conclusion: The findings from the current study confirm that several factors related to the lecturers, students and the institution influenced academic performance of student midwives. These findings concur with and are supported by studies conducted in an international and national context. The interconnectedness of the five principles of the EHNE theory in facilitating academic performance is also evident in the findings of the current study. Recommendations: The recommendations based on this study are that: 1) student midwives should take cognisance of self-interest when deciding on a career path, 2) lecturers should use a variety of teaching and assessment strategies to accommodate the different needs of student midwives, and ensure remedial work is done before reassessment and 3) nursing teaching institutions should ensure adequate supplies of material and human resources for teaching and learning.Item Clinical learning environment and supervision of student nurses' in a private nursing college : a cross sectional study(2021-05-27) Mbonambi, Maureen Phindile; Orton, Penelope Margaret; Radana, Nolundi (Jevu)ABSTRACT BACKGROUND: it is in my view that nursing education relates to the process of teaching and learning, given by nurse educators and clinical facilitators to nursing students. The teaching and learning process is conducted in a special Clinical Environment (CLE) entailing theoretical and practical learning. In addition to the teaching personnel, the clinical facilitators are responsible for placement of students in positive learning facilities for practical orientation in the clinical learning outcomes. It is these interactive processes that determine the state of readiness of the students in regards to their suitable attitudes required to provide nursing care. AIM OF THE STUDY: The purpose of this study is to describe nursing students’ experiences of clinical learning and clinical supervision at a private nursing college in eThekwini, in order to achieve improvements. METHODOLOGY: This study is influenced and guided by the quantitative, descriptive cross-sectional survey. It was done among student nurses (n = 120) at a private nursing college in eThekwini which offers the bridging course leading to registration as a Registered Nurse (R683) (South African Nursing Council 2006). In this study, data was gathered using the Clinical Learning Environment and Supervision (CLES) questionnaire developed by Mikko Saarikoski (2002), and it was analyzed by means of IBM SPSS statistics version 21. RESULTS: According to the study a general consensus has provided meaningful situations in the clinical learning environment. The clinical managers should give feedback to student nurses as it enhances their learning process. DISCUSSIONS: Findings in this study revealed that most participants were motivated and optimistic, and according to them, there was a positive clinical atmosphere; which is the most important features of a good clinical environment. RECOMMENDATIONS: It is encouraged that the clinical facilitators make more visits to the wards where the students are allocated for greater learning ability by the students. Professional nurses in the wards are to create a positive learning environment and use the presence of the students to maintain trust and prevent confusion.Item Views of nursing students regarding alcohol abuse and measures to prevent the abuse of alcohol(2021-05-27) Cebekhulu, Sibongile Vister; Razak, A.; Govender, S.Introduction:- Alcohol abuse is well-known phenomenon among nursing students, which has resulted in their not performing academically and at times, affecting the safety of their patients. Few studies have been done to establish nursing students’ views on alcohol consumption in South Africa, despite the fact that its abuse among tertiary level students in general is well reported. This makes it difficult to identify the factors that affect its consumption and the resulting problems that may arise from its abuse, and what measures need to be taken to ensure patient safety at all times. Aim of the study: The aim of the study is to determine the views of nursing students regarding alcohol abuse among nursing and measures to prevent the abuse of alcohol. Methodology: A quantitative descriptive cross-sectional survey design entailed the use of self-administered questionnaires across five KwaZulu-Natal College of Nursing campuses. Probability systematic sampling was used to first randomly select five campuses of the provinces’ nine campuses, and within which 320 students across the four years of study of the Diploma in Nursing programme were selected. Descriptive analysis was conducted on the quantitative data collected for their demographic details and the four study objectives using SPSS version 21. RESULTS: - The majority of respondents were African (78%), female (71%) aged 20 – 25 years (65%). The three highest factors affecting alcohol consumption were for experimental purposes 69%- (n = 219), peer pressure 70% (n= 222) and to cope with stressful situations 76% (n = 243). A similar number had engaged in illegal activities to obtain alcohol (5/319), experienced withdrawal symptoms when they stopped drinking (7/314) Attended Alcoholics Anonymous meetings (5/314), been hospitalized due to drinking (5/310) and been arrested for drunk driving (6/317). Conclusion: Nursing students should be reminded annually about the dangers of alcohol abuse and the consequences for their personal and patient safety. An emphasis being placed on helping them to cope with stressful situations and to not succumbing to peer pressure to consume alcohol.Item Preferred learning styles of first and third year nursing students in a diploma programme at a college in KwaZulu-Natal: a comparative study(2019-09-05) Subramoney, Linda; Pillay, P.; Razan, A.BACKGROUND Learning styles is described by Khanal, Shah and Koirala (2014: 1) as the way in which an individual processes, interprets and organizes information. Obtaining insight into the learning styles of students can benefit the learning and teaching experiences for students and lecturers respectively. The VARK learning style model is based on sensory modes of perception and assesses the “outer instructional preference ring of Curry’s onion ring model” (Mitchell, James and D’Amore 2015: 2). VARK is the acronym that represents the Visual, Aural, Read/Write and Kinaesthetic sensory modalities. AIM The aim of this study was to determine and compare the preferred learning styles of first and third year student nurses at Kwazulu-Natal College of Nursing (KZNCN), utilising the VARK sensory based model questionnaire in order to broaden the body of knowledge about learning styles in nursing education. METHODOLOGY A quantitative cross-sectional survey design was used to conduct the study. A census sampling survey method was used to collect data from first and third year students in the four year training programme at KZNCN. The sample size consisted of 290 respondents, which comprised of 145 respondents per year of study. Selfadministered questionnaires were used to collect the data. The data was analysed using SPSS version 23. Data was described graphically using descriptive statistics and inferential statistics were applied to detect significant trends in the data. RESULTS The majority of the respondents were found to be multimodal (77, 6%), preferring two or more sensory modalities, while the remaining 22, 4% were found to have unimodal learning style preferences. The most dominant learning style preference was Kinaesthetic, with a mean score of 6.54/SD=2.607 and the Visual modality was the least preferred (M=4.36/SD=2.315). The study showed no statistically significant relationship between preferred learning styles and year of study, age or gender respectively. Students that use English as their first language were reported to have a statistically significant Visual score than those that use isiZulu as their first language, with mean scores of 5.33 and 4.00 (p=.005) respectively. Coloured (M=5.43) and Indian (M=5.44) students were found to have a significantly higher Visual score than Blacks (M=4.14), F (2,286) = 6.759, p=.0001. Indians (M=7.08) had a significantly higher Read/Write score than Blacks (M=5.72), F (2, 286) =3.802, p=0.23. Students with previous higher education (M=4.93) have a significantly higher Visual score than those without previous higher education (M=4.17), p=.026. CONCLUSION According to the results of the study the majority of first year and third year students preferred multimodal learning styles. Lecturers should take into account various teaching methods when developing lesson plans in order to accommodate different learning styles. A huge gap in the body of knowledge regarding learning styles of individuals in South Africa warrants more research in this area.Item A model for managing psychological distress in undergraduate nursing students in South Africa(2018) Radana, Nolundi (Jevu); Basson, Petro MagdalenaThis study has its origins in the researcher’s own observations and experiences as a lecturer in mental health nursing. Specifically, it concerns the challenges associated with providing support and enabling environment for students presenting with psychological distress whilst on training. There is a dearth of literature in the Sub-Saharan Africa region regarding the prevalence of psychological distress amongst undergraduate nursing students, and there are no clear measures in place regarding how to deal with the situation, due to the lack of empirical evidence, leading to delayed referrals of students presenting with psychological distress, further compounds the psychiatric morbidity and ultimately the burden of disease in the country including institutions of higher education, which led to the formulation of the research rationale. The aim of this research study was to develop a model for management of psychological distress in undergraduate nursing students. A quantitative, descriptive, contextual and theory-generating research design was used. A 120-item questionnaire, consisting of four scales, was utilised to collect data from 848 undergraduate nursing students in the sampled universities in three provinces. SPSS-23 was employed in data analysis and descriptive, inferential statistics were generated using regression analysis, exploratory and confirmatory factor analysis-tests, analysis of variance (ANOVA) and Pearson’s correlation tests. Results showed significant evidence of psychological distress mainly related to social dysfunction and anxiety. Some of the identified factors contributing to more stress whilst on training were financial and time constraints (M=3.2432, SD= .97390); and level of education (M=3.2230, SD=.82644). Female students seemed to be experiencing more stress (M= 2.8199, SD=.99374) related to interpersonal conflict than do males (M=2.6131, SD=.90309), t (833) =2.617, p=.009). Analysis showed that older age is associated with more stress due to interpersonal conflict (r=.096, p=.005), while younger students experienced more stress from education (r=-.104, p=.003). Results showed a significant positive relationship based on personality traits, with neurotic personality traits contributing to all four areas of psychological distress, as well as an emotion- based coping styles. An intervention guideline in the form of a model for Managing Psychological Distress was developed.